Motivational Interviewing

Motivational interviewing is a collaborative counseling strategy designed to elicit and strengthen motivation for behavior change.1 A motivational interviewing style of communication can be incorporated into routine patient care. It has been applied to diabetes to encourage patients to discuss behaviors associated with self-management as well as to assist patients in their motivation and confidence for making changes that will improve their diabetes control. The principles and “spirit” of motivational interviewing are outlined in the following table.2

Collaboration: Partner with your patient.
Avoid taking the expert role.Evocation: Elicit the patient’s desires and reasons for change.
Give advice only with the patient’s permission.Autonomy: Respect and honor the patient’s autonomy.
Allow the patient to be in control of their decisions.Compassion: Actively promote the patient’s welfare.

This counseling strategy encourages health care professionals to engage in patient-centered communication by asking open-ended questions and probes, affirming patients when they share information, reflecting on what patients say, and providing statements that summarize the nature of the discussion. Motivational interviewing also recommends assessing a patient’s confidence, ability, and commitment to achieving agreed-upon goals, which are key components of successful behavior change.

Learning How to Use Motivational Interviewing in Your Practice

“Motivational interviewing is basically simple, but learning it is not easy.”2 Time and training are required to build competency in motivational interviewing. Numerous resources are available for motivational interviewing training. As a starting point, use the following link to access video vignettes that show examples of motivational interviewing in action during a patient encounter. Use the associated discussion guides to help you and your diabetes care team learn how to adopt a motivational interviewing style of communication with your patients.

Resources

Motivational Interviewing: Brief Overview highlights the basic fundamentals of motivational interviewing and includes examples of probes and questions that can be used to assess and follow up on the importance to patients of making changes, and the confidence of patients to make changes.

Let the Evidence Guide You

These two articles published in the Diabetes Spectrum journal provide clinical perspectives on motivational interviewing in diabetes.